It may still feel like spring, but ticks are already emerging across Maryland, sparking a sharp rise in emergency department visits.

Federal data show that tick bite-related visits nationwide are up more than 25 percent compared to last year, with Maryland and other northeastern states reporting some of the steepest increases.

Public health officials and physicians across the state are preparing for more cases of Lyme disease and other tick-borne illnesses.

Among them is a lesser-known condition that can cause dangerous allergic reactions to red meat.

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“This is shaping up to be a big year for ticks and tick-borne diseases,” said Thomas Hart, an infectious disease microbiologist at the Johns Hopkins University’s Lyme and Tickborne Diseases Research and Education Institute. He noted that the trend has been rising steadily for about twenty years.

Experts partly attribute the uptick to climate change, as warmer conditions allow ticks to thrive in broader regions.

Even the cold, snowy winter offered no reprieve, Hart said, because the snow can insulate and protect ticks until spring.

According to the U.S. Centers for Disease Control and Prevention, more than 89,000 cases of Lyme disease were reported nationwide in 2023, the most recent year available. Johns Hopkins experts say that the true number may be much higher, given that symptoms are often vague and cases frequently go unreported.

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In Maryland alone, there were 2,463 official Lyme disease cases in 2023.

That number climbed to more than 3,000 in 2024, according to the Maryland Department of Health, nearly triple the total recorded in 2020.

Deer ticks, also known as black-legged ticks, are common across the state, and as many as half of them carry the Lyme bacterium, according to Hopkins Medicine.

Lyme disease typically brings fatigue, fever, aches and sometimes a signature bull’s-eye rash. Left untreated, it can lead to more serious complications affecting the heart, joints and nervous system.

Doctors advise removing ticks promptly and contacting a physician if one has been embedded for longer than 36 hours or if flu-like symptoms appear after time outdoors. These recommendations are aimed at catching infections early, before complications occur.

Dr. Ibukunolupo Oni, an infectious disease specialist at Greater Baltimore Medical Center, said most doctors in Maryland are well-prepared to identify and treat tick-borne illnesses without an emergency visit.

Treatment generally consists of antibiotics, though some patients need longer courses if symptoms persist.

Oni added that a subset of patients experience lasting issues like fatigue and joint inflammation, sometimes referred to as post-treatment Lyme syndrome. “We can’t tell people not to go outdoors; try your best to prevent infection,” she said. “We’d rather you not have an infection if you can help it.”

Although Lyme disease dominates the data, ticks can spread other infections such as babesiosis and Rocky Mountain spotted fever, though Maryland reports far fewer of those cases.

Dr. Nicole Baumgarth, professor of immunology and infectious diseases at Johns Hopkins and director of the Lyme and Tickborne Diseases Research and Education Institute, said many of these illnesses begin with similar flu-like symptoms, making them challenging to identify.

Baumgarth stressed the need for better diagnostic tools and greater awareness of emerging tick-borne conditions. Among these is alpha-gal syndrome, spread by the lone star tick, which is also found in Maryland. The condition can cause allergic reactions to red meat, ranging from hives to potentially life-threatening anaphylaxis.

“We’re seeing it more and more when we go out and collect ticks,” Baumgarth said.

No vaccines currently exist for tick-borne diseases, although a Lyme vaccine candidate has shown progress in advanced studies. Hopkins experts said it could reach the market within a year but might face limited uptake due to the need for multiple doses.

For now, prevention remains the key strategy. Maryland’s health department has already launched its annual awareness campaign to remind residents how to protect themselves.

Dr. Meena Seshamani, Maryland’s health secretary, urged people to enjoy the outdoors while staying alert. Her statement emphasized the importance of “safeguard[ing] their health by knowing about ticks and the ways to protect people and pets against the diseases ticks carry.”

Ticks are most common in leaf piles, weeds, tall grass, shrubs and wooded areas.

To reduce exposure, state officials recommend using EPA-approved repellents such as DEET, picaridin or IR3535, wearing light clothing, tucking pants into socks, treating clothing with permethrin, showering soon after returning indoors and conducting thorough tick checks on children and pets.

As another tick-heavy season begins, doctors, researchers and health officials continue to urge vigilance while encouraging residents to safely enjoy Maryland’s natural spaces.